H.R. 3480: Health Coverage for Inclusive and Valued Families Act of 2025
This bill, known as the Health Coverage for Inclusive and Valued Families Act of 2025, aims to amend the Patient Protection and Affordable Care Act (ACA) by including fertility treatment and care as an essential health benefit. Here are the key components of the legislation:
Definition of Fertility Treatment and Care
The bill specifies that fertility treatment and care encompass a range of medically appropriate services, including:
- Preservation of human oocytes, sperm, or embryos for future reproductive use.
- Various forms of artificial insemination.
- Assisted reproductive technology, such as in vitro fertilization (IVF), with guidelines on the number of oocyte retrievals and embryo transfers permitted.
- Genetic testing of embryos.
- Medications prescribed for fertility-related purposes.
- Gamete donation.
- Any other related services and procedures the Secretary of Health and Human Services finds appropriate.
Insurance Coverage Requirements
The legislation imposes specific requirements on health insurance plans that provide coverage for medical and surgical benefits as well as fertility treatments:
- Financial requirements for fertility treatment must not be more restrictive than those for other medical and surgical benefits.
- There cannot be separate cost-sharing requirements for fertility treatment and care benefits.
- Treatment limitations for fertility benefits must be comparable to those applied to other medical benefits.
- Health insurance issuers cannot deny fertility treatment benefits on the basis that an individual lacks a diagnosis of infertility.
Utilization Management Tools
If a health insurance issuer employs any utilization management tools for fertility treatment, such tools must be analyzed and reported. This includes providing specific coverage terms, factors that determine when these tools apply, and ensuring that the tools align with clinical guidelines.
Reporting Requirements
The Comptroller General of the United States is required to publish a report outlining compliance and analyses of these insurance coverage obligations annually, starting from one year after the enactment of the bill.
Effective Date
The provisions of this bill would take effect for plan years beginning one year after its enactment.
Relevant Companies
- ABBV (AbbVie Inc.): As a pharmaceutical company that develops medications related to fertility treatments, AbbVie may see changes in coverage policies that could influence the demand for its products.
- MDT (Medtronic plc): Medtronic, involved in assisted reproductive technologies, may experience changes in service coverage and utilization of their technology due to the new regulations.
- LIFE (Life Insurance Company of North America): As a company that may sell fertility-related insurance policies, LIFE’s products could be directly impacted by these mandates.
This is an AI-generated summary of the bill text. There may be mistakes.
Sponsors
1 sponsor
Actions
2 actions
| Date | Action |
|---|---|
| May. 19, 2025 | Introduced in House |
| May. 19, 2025 | Referred to the House Committee on Energy and Commerce. |
Corporate Lobbying
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